For women who are healthy, relatively young, don’t have a history of autoimmune issues—what preventative steps can they take to protect themselves?
There are five factors that influence all chronic disease, particularly autoimmunity:
Eat a clean, organic (free of GMOs) diet—I know those feel like buzzwords, but having a healthy diet really is so important to staying healthy and protecting against autoimmunity.
I am a big fan of eating gluten-free. Gluten is one of the main causes of leaky gut (see below) as it triggers the release of zonulin, a chemical in your intestines that instructs the tight junctions in your gut to open and remain open. When these tight junctions are open and we eat gluten, the gluten which normally could not get into your bloodstream now does. Your immune system knows the gluten is foreign, and it goes to attack the gluten; however, gluten looks almost identical to our thyroid tissue—this process is called molecular mimicry—so our immune system can end up attacking our thyroid along with the gluten. The number-one thing you can do to prevent (or reverse) thyroid issues and autoimmunity is to go gluten-free.
Also: Casein, a protein in dairy, has a very similar structure to gluten, and about 50 percent of people who are gluten-intolerant are casein-intolerant, as well, because of molecular mimicry.
Take good care of your gut: Add collagen to your diet with bone broth. In addition to eating well, take a quality probiotic.
Be cognizant of what medications you’re taking. Antibiotics, acid-blocking medications, steroids, anti-inflammatory drugs like Motrin can all cause leaky gut.
If you might have an infection, such as Candida overgrowth, see a doctor. If you’re not feeling well, if your gut is out of whack, if you have leaky gut—it’s vital that you heal it. [Dr. Myers’s tips here are a good start. You can read more from Myers on gut health on goop—here and here—and there’s also her online gut course.]
Limit your exposure to toxins as much as possible—in the environments, products, and food:
Be aware of mercury exposure from dental amalgams and fish consumption.
Again, eat organic food when you can.
A lot of people think to filter their drinking water, but not their shower or bath tub water.
Avoid endocrine disruptors, such as parabens (preservatives) and phthalates (plasticizers), in your cleaning and beauty products.
Stay away from plastic products made with BPA.
On the flip side, one detoxification tool that is particularly great at getting rid of these toxins is the infrared sauna—spend time in one regularly if you can. (They are also amazing at relieving stress—see below.)
If you’re a woman burning the candle at both ends, you’re not going to get rid of stress. But what do you do to relieve stress? This should be individualized—the most important thing about stress relief is that the routine/habit/practice resonates with you—otherwise…it’s not going to relieve your stress. A lot of people like yoga (of course). I’m type A and I like apps that have trackers that allow me to see my progress, like Headspace, HeartMath, and Muse. I also love acupuncture and float tanks.
This piece is inherently more complicated, but if you have, or suspect you have, an infection (like Epstein-Barr, which causes mono), absolutely go see your doctor.
Are there certain foods/supplements that are particularly protective/good on defense?
Glutathione is the body’s primary detoxifying antioxidant—you can enhance your body’s production of it by eating cruciferous vegetables, adding onion and garlic to your dishes, and taking a glutathione-boosting supplement.
To combat inflammation, I recommend adding turmeric to your diet and supplementing with Omega-3 fatty acids.
As mentioned earlier, I also suggest taking a probiotic. Sixty to eighty percent of our immune system lives in our gut, below a one-cell thick layer. Probiotics help you maintain healthy levels of good bacteria and keep your immune system running smoothly.
Is there a typical age of occurrence for most autoimmune diseases (if so, what is it)?
Autoimmune disease is 75 percent more common in women than men, and it typically occurs during time periods when women are going through hormonal changes: right after childbirth, perimenopause, menopause—so between the ages of thirty and sixty.
You’ve mentioned that you’re seeing younger patients with autoimmunity and thyroid issues. Why do you think that is? Is there a larger trend going on?
Yes, I’m seeing a lot of younger patients—people with autoimmunity issues in their twenties. Autoimmunity has gone up 300 percent in the last fifty years. And it’s not because we are getting better at diagnosing it. The environmental factors that cause leaky gut—the gateway to autoimmunity—have increased in quantity and intensity, and they are hitting us sooner in life: More women are having caesarean sections, fewer women are breastfeeding, antibiotics are more prevalent, people are eating more processed foods and more GMOs, gluten is found in everything and we are eating lots of it, and we have higher stress levels. I think of it like a glass of water—we are adding more and more drops to our glass, and earlier in life, and it’s necessarily starting to overflow.
Why is it important to take supplements if you’re not sick? Why would someone suddenly begin taking supplements if they never have before?
One reason is to prevent health issues. But beginning and following a supplement regimen is also about reaching your optimal health. When the FDA came up with the recommended daily intake of nutrients such as, say vitamin C, they gave the minimum amount that a person would need not to get scurvy. They weren’t looking at the optimal amount you should be getting to be healthy, and the recommended amounts—from the 1920’s—have not been updated.
What makes our nutrient gap wider is that our food supply is not as nutrient-rich as it once was. This is in part because the average diet is more processed. Also, if you have leaky gut issues, you might not be absorbing nutrients that your body is consuming. But even if we are eating a good, organic diet, we still aren’t getting all the nutrients we need, or as many as our parents and previous generations got from their food because the soil quality today is much poorer, less nutrient-rich. This is why a good multivitamin is so important.
Another reason some people choose to take supplements is to counterbalance genetic mutations or otherwise compensate for negative influences of certain genes they have. For instance, I have the gene mutation for MTHFR, which means I don’t process folate very well—I can only convert 10 percent of my folate intake. So I supplement with more folate than I would if I didn’t have this mutation. (You can get genetic testing done via 23andMe.com.)
What do you recommend to first-time supplement takers?
Be sure you are taking a good quality supplement. Most of the time when people say they aren’t feeling well after having taken supplements, they are taking low quality supplements. I don’t find this to be an issue with quality supplements like Balls in the Air, which are designed to be safe, digestible, absorbable.
You want your supplement regimen to include:
A good multivitamin because that will cover what you lose with our poor soil quality.
Fish oils (Omega-3s), which are effective anti-inflammatories. For a lot of people, the proportion of Omega-3 fatty acids to Omega-6 is too low.
A supplement (like a glutathione booster) that helps with detoxification because we are unfortunately living in a toxic world.
Vitamin D: Most people are vitamin-D deficient.
Last, a lot of patients ask me about if they should take supplements with food or not: In general, multivitamins and the B vitamins, vitamin D, anything that is fat soluble, is better taken with food.
Amy Myers, M.D. is the founder and medical director of Austin UltraHealth, a functional medicine clinic based in Austin, Texas. Dr. Myers specializes in women’s health issues, particularly gut health, thyroid dysfunction, and autoimmunity. She is also the New York Times bestselling author of The Autoimmune Solution and The Thyroid Connection.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.